How to pivot when it all falls apart with Dr. Lisa Baumann Kreuziger

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Welcome to the Clinician Researcher podcast, where academic clinicians learn the skills

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to build their own research program, whether or not they have a mentor.

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As clinicians, we spend a decade or more as trainees learning to take care of patients.

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When we finally start our careers, we want to build research programs, but then we find

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that our years of clinical training did not adequately prepare us to lead our research

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program.

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Through no fault of our own, we struggle to find mentors, and when we can't, we quit.

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However, clinicians hold the keys to the greatest research breakthroughs.

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For this reason, the Clinician Researcher podcast exists to give academic clinicians

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the tools to build their own research program, whether or not they have a mentor.

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Now introducing your host, Toyosi Onwuemene.

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Hello everybody.

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Welcome to the Clinician Researcher podcast.

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I'm your host Toyosi Onwuemene.

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I am excited to be talking with you today, and especially because I have an awesome,

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awesome guest today.

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It's Lisa Baumann Krautsiger, and she's going to tell you in a few minutes how to really

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say her name, but it's a pleasure to have you here on the show, Lisa.

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Thank you for being here, and I want to invite you, please, to introduce yourself to our

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audience.

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Thank you so much for having me.

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So yes, my name is Lisa Baumann Krautsiger.

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I kept Baumann for a reason, but since Krautsiger is horribly hard to pronounce.

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I'm a clinician investigator at Bursby Blood Research Institute and the Medical College

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of Wisconsin in Milwaukee.

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My clinical work involves benign hematology or classical hematology, and my research is

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in thrombosis.

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Thank you, Lisa.

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You talked about being a clinician investigator or clinical investigator, and I think there's

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so many terms that we can use to describe it.

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I think sometimes there's a sense of we're clinical scientists, we're clinician scientists,

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clinician researchers.

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Is there a specific name you kind of identify with the most?

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Yeah, I don't know.

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I try not to get too tripped up with the terminology, to be honest.

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Probably within the structure that I work in, investigator is the term, and that what

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goes through both basic scientists and translational scientists and clinician scientists.

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I do probably prefer the term clinician investigator because it then speaks to both what I study

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as well as then puts me in the same sort of structure that other areas of research are

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within our institute.

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Sure, sure.

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Thank you for clarifying that.

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Now, let me ask you about the defining moment, if there was one, or maybe the series of defining

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moments at which you felt like, yeah, you know what, I'm not just a clinician.

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I'm a clinician investigator.

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Yeah, I thought this question was really interesting because I actually came to medicine in the

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opposite direction.

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So I always through high school and into college knew I was going to be doing biology and doing

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research.

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And probably my defining moment was when I was doing an internship and half of my time

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I spent it in the lab doing laboratory investigation and half of my time then I was able to shadow

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a clinician.

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And it was a very gut response to the days that I got to go in and see patients and really

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showed me that I wanted to be a clinician as well.

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And so I probably always knew I was going to be doing research and added the clinical

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piece to it.

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Throughout my career, I've gone back and forth between doing laboratory based investigations

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and doing clinical investigations.

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And I think that's helpful for me to then understand both realms in order to bridge

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that gap a little bit better.

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When I'm seeing a patient, it's helpful for me to be able to say, well, we don't have

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the answer to that question, but we are looking into it in this way or that way.

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Or say, you know what, that's a great question.

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I'm going to add that to my list of things we don't know and things we probably need

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to look into.

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And then on the opposite side, when I'm doing and looking at either looking at grants or

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thinking about projects, I need to really focus that in on what's important to the patient

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in front of me, because there are so many things that you could do and really trying

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to anchor the research projects and the time spent on things that are really going to help

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patients.

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So it kind of goes both ways for me.

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Sure, sure.

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And that's really unique, at least I think from my perspective, Lisa.

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I think many, many people come in from the perspective of I've been doing patient care

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for so long and now I want to do research.

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And that can be hard because they haven't actually even ever done anything in research

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at all.

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And so, but for you, it sounds like you've kind of grown both perspectives at the same

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time.

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Yeah, absolutely.

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And I'm wondering how has that been an advantage for you?

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Yeah, I think the biggest thing is trying to, as I mentioned, bridge that gap because

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there aren't a lot of people that understand both laboratory-based investigations and clinically

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based investigations.

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So able to look at, for example, studies that are looking at biomarkers in clinical diseases.

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Well, most of the time that those are laboratory-based investigations and trying to understand the

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techniques and the pluses and minuses of it.

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And from the opposite way, so we have multiple investigators that are studying different

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pieces of their either structure, their protein of choice, or whatever else from a laboratory

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perspective and trying to give them and see where we might be able to translate that and

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trying to set up the laboratory-based investigations to answer the ways that we can potentially

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translate that to human and patient care.

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So I think that is a distinct advantage.

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It leads to a lot of difficulty in trying to understand or pick what am I going to go

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see when at an annual meeting or what am I going to do in terms of where my focus is

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going to be for, what journals do I read?

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What should I review?

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What projects am I going to be involved in?

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When you're kind of straddling both, it can be a little challenging from that perspective.

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So what I hear is that your work is translational and you're also in a sense an interpreter.

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So you're translating between the clinicians and the lab investigators to a great extent

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as well, just even in terms of interpreting what studies need to be done, not just even

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in terms of what the studies are that you're doing, but in even communicating, I think,

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between groups.

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Is that fair to say?

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Yeah, actually, that's a great way to think about it.

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I think about it also in terms of translating things to our patients.

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So we do that as a clinician every day, translating classical hematology to other areas of medicine.

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So I think maybe that's just a way for me to frame who I am.

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I'm a translator of knowledge.

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I love it.

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I love it.

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Well, Thomas, what has been the biggest challenge for you in this journey?

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Yeah, I think there have been several.

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I think one of the big things is when I started my research career, I was focusing on device-related

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thrombosis.

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And that was really in mostly mechanical circulatory support.

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And my first grant was in that as a pilot study.

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And very shortly after I received that pilot study, my surgeons lacked.

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Therefore, the entire mechanical circulatory support program fell apart.

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And so the big lesson for me with that is that it's very difficult to study as well

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as to put your career in others' hands.

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I was able to make some continued progress with that group by reaching out to other surgeons

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and other programs.

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And it is an area that I'm still very interested in.

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But it definitely is a major challenge when you don't...

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The patients aren't primarily yours.

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And I think we have that in classical hematology in many aspects, especially in thrombosis.

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So any of our work in cancer-associated thrombosis, our oncologists, their primary patients are

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theirs.

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So in a lot of ways, it's ensured that I had honed my skills in collaboration.

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But it does make things definitely challenging when you don't own...the patients aren't

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primarily yours.

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So, Rand, thank you for sharing that perspective.

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And I feel like I heard two things that really, really stood out to me.

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One is just how strong you've become through that process of forming multiple, not just

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one or two, but it sounds like multiple collaborations to move your work forward.

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In a sense, I look at it as like you're diversifying your portfolio.

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It's like, well, if one thing fails, other things move forward.

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But the other piece that really, I think, resonated with me is that putting your career

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or putting your research in one person's hands or in one group's hands.

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And I just wonder, other than the collaborations, how else have you done that?

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What would you recommend to someone else who is in a similar situation?

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But maybe their surgeons haven't left and they're feeling happy that things are going

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well.

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Yeah.

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I mean, there's a fine balance here.

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I definitely agree that you need to diversify your portfolio in terms of projects that are

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going on or other areas, because not every, I promise you, only a very few limited amounts,

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a number of your grants are going to be funded.

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That's just the reality.

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And you don't know what's going to necessarily stick.

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So or what's, you know, what hurdles you're going to have in one project versus another.

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And so definitely having potentially a couple of different areas that you are working through

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and having projects at different stages also helps a lot.

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And that's obviously hard when you're at the beginning part of your career, when everything

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is just beginning.

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But hopefully, you know, potentially through a mentor, you could come into a project that's

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already ongoing.

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So you can, again, try to not only diversify in topics, but diversify in stages of where

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a project is.

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And the other thing is to probably have more than one mentor or more than one sort of group

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that you're working on.

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You know, there's definitely people change institutions, as I had mentioned, happened

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to me, but also mentors leave and other clinical collaborators leave.

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And I think it's been important to that that doesn't completely derail everything that

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you are currently working on.

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The other thing I wanted to mention in terms of collaboration is at the same time that

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that happened to me with my mechanical circulatory support research plundering, for lack of a

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better way to say it.

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The other thing that happened right at that time was the opportunity to form the clinical

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research network that I run now called Venus.

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So that was back in 2016, and it was a bit serendipity, which a lot of times plays into

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good things that the Canadian group was VT researchers, Alcan Vector, they had received

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grant funding to actually form an international network.

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And as a piece of that, they were looking for US based researchers to really formalize

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a US network.

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And so that really was a great opportunity and has really led a vast majority of my research

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since that time.

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And so the other kind of thing message to send is that, you know, when one area, the

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other benefit of diversifying is one area is not going well, sometimes other things

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come along.

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And you have to be open to that as well, because you don't necessarily know where each of the

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things are going to lead.

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That's really, really, really well said, Lisa.

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Thank you for sharing that.

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What I see is someone who's leading their career.

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It's like, yes, other things may not be working in this area, but because I'm leading, I'm

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going to move to this area that's working well.

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And I think that even as a young person starting in the field, you are leading in terms of

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you're the one saying, okay, I'm going to work with this mentor, I'm going to try to

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work with this group.

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And in a sense, as you're leading yourself, then you put yourself in great positions to

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be ready for opportunity when it comes.

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And so you speak of being lucky.

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And I think of you as someone who kind of just had done a lot of the right things and

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was in the right place to recognize an opportunity when it came, and you were ready to run with

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it as well.

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Yeah, that's absolutely true.

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I mean, you have to put yourself out there, but you have to also be willing to do it and

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put the hard work in.

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Like, you know, when we started, when we started the Venus organization, no one was, it wasn't

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being covered by anything in my, in my career.

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I didn't get a point, whatever FTE to run Venus.

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It was, it was my own volunteer time and it was a lot of work.

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And we then got a lot of fantastic help from a lot of other organizations that really helped

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us get the, get the group off the ground.

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And so it is both, right?

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It's having the confidence and being willing, willing to put yourself out there, taking

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the opportunities when they do come and then putting in the hard work and, and making sure

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that it is something that you are proud to be a part of.

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Lisa, you've spoken of hard work.

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You spoken of collaborators leaving, things not working.

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This is a hard journey you're describing.

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And I'm wondering what's kept you in the game.

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I think part of it is just again, the desire to always know more.

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I think it's the trying to take care of our patients better and really answer the questions

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that they, and we have, but we don't know yet.

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And so I think that is the biggest thing that, that drives me.

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I mean, I see how much we've been able to improve patient care, even in, in my career.

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And I'm hopeful and want to be involved in the next steps of all of that.

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Because in the end, that's where, you know, as a, as a doctor, my, my role is to make

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patients better.

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And by doing research, I see that as ability to forward their care as well.

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That's really, that's really amazing.

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What I hear in that is someone who's not satisfied with the status quo.

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Yes, we're taking great care of patients, great care of patients, but how can we do

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that better?

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And seeing research as an opportunity to actually improve the care of patients currently, and

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in fact, being rewarded by you seeing some of the research you're doing come to be able

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to be used clinically to help patients get, be better.

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Absolutely.

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That's the, that's the coolest thing to be able to do.

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That is very cool.

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That is very cool.

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And I'm so appreciative of you coming and sharing all this insight with us.

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And we're kind of rounding up and getting to the end of the show.

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I wanted to ask you if you had one word or one piece of advice that you wanted to share

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with a young person who's just getting started and wondering, okay, maybe I should just focus

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on clinical care to the best of my knowledge, even though they really want to do research.

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What would you share with them?

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What advice would you give them?

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I would suggest to stick with it.

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I think that it does seem daunting when you first start, and hopefully people are better

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at sharing the ups and downs, especially people who have been successful in their careers,

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but just know that it is definitely worth it and being able to then take what you're

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learning and translate that into patient care is incredibly rewarding.

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So stick with it.

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You don't, even if you don't make a research, you're 80% of what you do every day.

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That's okay.

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Even if you only make it a quarter of what you do or half of what you do, and then you

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get to decide whether that's enrolling people in clinical trials, whether that's designing

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trials, whether that's doing retrospective reviews.

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I think there's, and that's what we've really tried to do with the Venus Network is we have

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people who are involved at all of those stages.

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We have people who are leading the projects.

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We have people who participate in the projects, which is absolutely essential.

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So you don't have to have a master's in clinical research in order to participate in clinical

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research.

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If you want to design the trials, go get your master's in clinical research because it definitely

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will help you in not only face validity of being able to design them, but also the underlying

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knowledge of how to do it.

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So there are lots of ways that you can participate in research and you can then make that as

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large or as small of a part of your career.

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That's super awesome.

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Thank you, Lisa.

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I hear you saying the sky's the limit.

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What do you really want to do?

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And that's what you should go for because it does give you the most satisfying, fulfilling

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career to be doing things that are meaningful to you.

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And there are many opportunities to participate in research in different ways and with different

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people.

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And yeah, that's definitely something that if you are listening today, you should pay

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attention to.

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Don't think you can't do it.

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Don't give up before you start.

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You've done many hard things.

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You've come through medical school, come through residency, maybe going through fellowship

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or have finished fellowship, but you've done a lot of hard things.

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So hard things are not easy to do, but you've been doing them.

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And so even though it can be hard to succeed in research, you can, and it's definitely

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worth sticking with it because it's very fulfilling and very rewarding as Lisa has shared with

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us today.

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Lisa, I just want to say thank you for being with us here on the show today, for sharing

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your insights and just for being an all around inspiration.

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Thank you for being here.

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Oh, thank you for those kind words.

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And thank you so much for having me.

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It's great to see you.

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You're welcome.

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Thank you.

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Okay, everyone.

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So you've heard Lisa.

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Keep going, keep working at it.

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And if you need a piece of encouragement, if you need just, just to keep being encouraged

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along the journey, which can be hard, definitely reach out to us, sign up for our weekly newsletter,

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docsleaveresearch.com.

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And we'll be happy to just keep you engaged and keep you thinking about different ways

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to succeed in research.

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All right.

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This is the end of today's show.

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It's been a pleasure hanging out with you and I look forward to seeing you again next

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time.

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Take care.

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Thanks for listening to this episode of the Clinician Researcher Podcast, where academic

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clinicians learn the skills to build their own research program, whether or not they

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have a mentor.

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If you found the information in this episode to be helpful, don't keep it all to yourself.

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Someone else needs to hear it.

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So take a minute right now and share it.

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As you share this episode, you become part of our mission to help launch a new generation

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of clinician researchers make transformative discoveries that change the way we do healthcare.